Postoperative organ dysfunction assessed using simplified eSOFA is associated with mortality: a single-center...

This study aimed to determine the association between postoperative organ dysfunction evaluated using eSOFA, a simplified measure of organ dysfunction, and postoperative mortality following noncardiac surgery.

This study retrospectively analyzed adult patients who underwent noncardiac surgery under general anesthesia between 2009 and 2019. The primary exposure was postoperative organ dysfunction evaluated using eSOFA within 2 postoperative days (positive eSOFA), and the primary outcome was 90-day mortality. Multivariable Cox regression analysis was employed to investigate the association between positive eSOFA and 90-day mortality. In a subanalysis of patients in the surgical intensive care unit (ICU), the predictive performance of the number of eSOFA-positive items for 90-day mortality was compared with those of the Sequential Organ Failure Assessment (SOFA) score and the Acute Physiology And Chronic Health Evaluation (APACHE) II score using Harrell's C-statistic.

This study included 24,558 patients, of whom 7.5% had positive eSOFA, and the postoperative 90-day mortality was 0.9%. Positive eSOFA was independently associated with the occurrence of 90-day mortality (adjusted hazard ratio [HR]: 3.03, 95% confidence interval: 2.16-4.25, P < 0.001). As the number of positive eSOFA items increased, the adjusted HR for 90-day mortality increased. The C-statistics for predicting 90-day mortality in surgical ICU patients using the number of eSOFA-positive items, SOFA score, and APACHE II score were 0.72 (0.65-0.79), 0.73 (0.65-0.80), and 0.74 (0.68-0.81), respectively.

Postoperative organ dysfunction evaluated using the eSOFA within 2 postoperative days was independently associated with 90-day mortality in patients who underwent noncardiac surgery.